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Objective:To explore the risk factors of hospital death in patients with acute Upper gastrointestinal bleeding, analyze the role of emergency endoscopy, and provide reference for grass-roots hospitals to carry out related work.Methods:A total of 370 patients with acute Upper gastrointestinal bleeding hospitalized in the Xinghua People′s Hospital from January to December 2022 were included, 278 of whom underwent emergency gastroscopy. The common causes and locations of acute Upper gastrointestinal bleeding were analyzed, and the influencing factors of death from acute upper gastrointestinal bleeding were analyzed by logistic regression.Results:Among 370 patients with acute Upper gastrointestinal bleeding, the majority were male [67.3%(249/370)], the median age was 70(57-78)years old, and the median hemoglobin level at admission was 72(57-96)g/L. Among them, 278 patients underwent gastroscopy, and 130 patients received blood transfusion treatment of 2(1.5-3.5)units of red blood cells transfusion. The median length of stay was 5(4-7)days. The age of the endoscopic group was younger than that of the non endoscopic group ( P<0.001), and the hemoglobin level was higher than that of the non endoscopic group ( P<0.001). The proportion of hemostatic drug use and blood transfusion was lower than that of the non endoscopic group ( P=0.027, P<0.001). In patients undergoing gastroscopy, the causes of upper gastrointestinal bleeding included 144 cases (51.8%) of ulcer related bleeding, 61 cases (22.0%) of bleeding caused by acute mucosal lesions, 27 cases (9.7%) of bleeding caused by tumors, 12 cases (4.3%) of bleeding caused by cardiac tears, 5 cases (1.8%) of bleeding caused by vascular malformations, and 29 cases (10.4%) of bleeding caused by varices. The bleeding sites included: 170 cases (61.1%) had bleeding from the stomach, 53 cases (19.1%) from the esophagus, 54 cases (19.4%) from the duodenum, and 1 case (0.4%) from gastroduodenal compound ulcer bleeding. Among all patients, 19 died in the hospital, and among 92 patients who did not undergo emergency gastroscopy, 16 died, with a mortality rate of 17.4%; Among 278 patients who underwent emergency gastroscopy, 3 died, with a mortality rate of 1.08%. Logistic single factor regression analysis found that the elderly (>70 years old), low hemoglobin (<70 g/L), blood transfusion and emergency gastroscopy were the influencing factors of hospital death in patients with acute upper gastrointestinal bleeding. Multivariate regression analysis showed that emergency gastroscopy ( OR=0.043, 95% CI: 0.010-0.198, P<0.001) could reduce the hospital death of patients with acute upper gastrointestinal bleeding. Conclusions:Acute upper gastrointestinal bleeding is common in elderly patients. On the basis of stable hemodynamics and early endoscopic examination, identifying the cause and combining traditional drugs for endoscopic hemostasis can improve the prognosis of patients and reduce the mortality of acute upper gastrointestinal bleeding.
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OBJECTIVE@#To study the expression of PSMA7 and its effect on proliferation, invasion and migration of gastric cancer and subcutaneous tumorigenesis in nude mice. >and subcutaneous tumorigenesis in nude mice.@*METHODS@#Specimens of tumor tissues and paired adjacent tissues were collected from 60 patients with gastric cancer for detecting the expression levels of PSMA7 using immunohistochemical method. Gastric cancer cell line SGC7901 was transfected with a lentiviral vector to inhibit PSMA7 expression, and the changes in cell proliferation and invasion were observed using cell counting kit-8 (CCK-8), clone formation assay and Transwell assay. A BALB/c mouse model bearing subcutaneous gastric cancer xenograft was established using SGC7901 cells with stable PSMA7 knockdown to assess the effect of low expression of PSMA7 on xenograft growth.@*RESULTS@#Gastric cancer tissues expressed significantly higher levels of PSMA7 than the paired adjacent tissues ( < 0.05). In SGC7901 cells, interference of PSMA7 expression significantly inhibited the cell proliferation and invasion ( < 0.05). In the tumor-bearing BALB/c mice, the xenografts derived from SGC7901 cells with PSMA7 expression interference showed significant growth suppression as compared with the control xenografts ( < 0.05).@*CONCLUSIONS@#PPSMA 7 is overexpressed in gastric cancer tissues, and PSMA7 knockdown inhibits the proliferation, invasion, migration and subcutaneous tumorigenesis of gastric cancer cells in nude mice.